'I've come to court . . . to ask you to assist me in having a peaceful, dignified death'

The imagery represented justice at its most humane. Three judges of the High Court deserting their lofty dais for a bench usually occupied by the media, in order to sit at eye-level with a plaintiff.

They had little choice. The architects of the venerable, old courtroom off the Four Courts’ Round Hall clearly never envisaged a plaintiff like 58-year-old Marie Fleming, formerly the assistant director of a university department, now terminally ill with multiple sclerosis and begging the court to be spared a “horrible” death.

Shortly before 2pm, she came into court in her wheelchair, with her partner of 18 years, Tom Curran, and her two children and stepson, her russet hair and jewel-red brocade jacket bringing a flash of colour to a sombre courtroom, packed with lawyers.

Only as her partner performed the slow, infinitely gentle tasks of a carer did the full extent of her disability become evident; carefully removing the blankets on her lap showing glimpses of the three-stone weight loss; peeling off the black gloves revealing the special, splinted gloves beneath, then gently rearranging her stiff, useless fingers; offering her sips of water through a straw, and tenderly moistening her lips with ointment.

Collapsed shoulder

Later she would give evidence of the collapsed shoulder which impinges on her lung and breathing function, of the 22 pills she needs to ensure her limbs are pliable and supple for the seven carers who come in to shower, toilet, dress her and put her back in the wheelchair.

“That takes 2½ hours. I often pass the afternoon sleeping, trying to overcome the tiredness of getting showered.”

On good days, she tries to get on with a book she is writing, with the help of a friend who types up her dictation. Then another carer “comes back at 6 o’clock to put me to bed. Then the day starts all over again the next morning . . .”

She described the pain – “so severe I’m afraid my head will burst open” – and the spasms “which wreck my body, which pierce my very heart . . . My voice and swallow have progressively got worse. I would choke at least four times a day, when my back has to be thumped to get me starting to breathe again”.

Her death would most likely be caused by choking but first her speech – her only means of communication – will get worse. “I’ve come to court today, whilst I still can use my speech, my voice, to ask you to assist me in having a peaceful, dignified death . . . in the arms of Tom and my children.”

“Very supportive”

None of her family winced or wept as Ronan Murphy SC led her through this evidence. This was nothing new to them. “I have talked to all of my children and they know how I feel,” she said in slow, laboured but clearly enunciated words.

“There were a lot of tears shed and questions asked. But they see me and how my life has deteriorated . . . And they are very, very supportive”.

As the judges listened intently, lined along the hard bench with their hands in their laps, she told them she knew a woman with MS who had starved to death, who had died of hunger and thirst, she said. “That’s not what I want. I want to go peacefully in my own home, with the people I love around me.”

Palliative care is “not acceptable” to her. “I don’t want to be kept in a state whereby you’re being given ingestions of massive doses of painkillers that may alleviate the symptoms of pain but leave you in a comatose state. To be kept in a state of not being able to smell the flowers, or to see my beautiful garden or just see the changing of the seasons; that’s not acceptable to me to miss all that. I would be doing myself an injustice.”

She has no fear of death. “I am at peace with the world . . . I have arranged my funeral – a wicker coffin, jazz music to play and my life to be celebrated.” She had even asked that her coffin be transported to the crematorium in the back of a car, to spare expense.

She and her family discussed her method of assisted suicide “non-stop”, she said.

She had squarely confronted the methods of suicide available to her now in her paralysed state. “The only way that is left for me to die is with the use of gas. By this I mean the usage of gas through a face mask. I could assist myself, either by moving my head to initiate the flow of gas or by blowing into a tube that would release the gas . . . I know I would be able to do it. I have practised it in my mind over and over again . . .”

Independent observer

Or a doctor could put a cannula into her arm to pass poison into her veins, she said.“My physician has stated she wouldn’t kill me but that she would help if it were lawful . . .”

She would welcome the presence of an independent observer, she said. “We have nothing to hide . . .” After some 30 minutes, the questions ceased. None of the opposing counsel chose to cross-examine nor did the judges have any questions. As the courtroom emptied, the slow, agonising tasks were performed in reverse and the dignified little group moved slowly back to the van in the yard.